Comparison of Computer-Assisted and Conventional Local Anesthesia in Children With Molar-Incisor Hypomineralization

Condition(s) studied

Investigational drug(s) / intervention(s)

Computer-Controlled Local Anesthesia: Local anesthesia will be administered using the SleeperOne computer-controlled local anesthetic delivery system according to the manufacturer's pediatric protocol. The device electronically controls the flow rate and pressure of the anesthetic solution. A 4% articaine solution with 1:100,000 epinephrine will be administered before restorative treatment of the MIH-affected permanent molar.

Conventional Local Anesthesia: Local anesthesia will be administered using a conventional dental syringe. Buccal infiltration will be used for maxillary teeth, and an inferior alveolar nerve block will be used for mandibular teeth. A 4% articaine solution with 1:100,000 epinephrine will be administered before restorative treatment of the MIH-affected permanent molar.

Study summary

The main questions this study aims to answer are:

Does computer-controlled local anesthesia cause less pain and anxiety than conventional local anesthesia in children with molar-incisor hypomineralization (MIH)?

Is there a difference between the two methods in anesthesia onset time, injection duration, physiological responses, and the need for additional anesthesia?

Researchers will compare computer-controlled and conventional local anesthesia in children aged 8-12 years with MIH. Each child will receive both anesthesia methods during separate dental visits, on comparable permanent molar teeth, to determine which method is more comfortable, effective, and preferred by children.

Eligibility

Primary outcome measure(s)

• Injection pain assessed using the Wong-Baker Faces Pain Rating Scale — Immediately after completion of local anesthetic injection at each treatment visit
  Pain intensity will be assessed during local anesthetic injection using the Wong-Baker Faces Pain Rating Scale (score range: 0-10; higher scores indicate greater pain).
• Injection pain assessed using the Visual Analog Scale (VAS) — Immediately after completion of local anesthetic injection at each treatment visit
  Pain intensity will be assessed immediately after local anesthetic injection using a 100-mm Visual Analog Scale (0=no pain, 100=worst imaginable pain; higher scores indicate greater pain).
• Behavioral pain assessed using the Face, Legs, Activity, Cry, Consolability (FLACC) Scale — Periprocedural (during local anesthetic injection at each treatment visit)
  Behavioral pain will be assessed during local anesthetic injection using the Face, Legs, Activity, Cry, Consolability (FLACC) Scale (score range: 0-10; higher scores indicate greater pain).
• Successful local anesthesia during restorative treatment — Immediately after completion of restorative treatment at each treatment visit
  Successful local anesthesia will be defined as completion of cavity preparation and restorative treatment without the need for supplemental local anesthesia and without interruption of treatment because of pain. The outcome will be reported as the percentage of treatment visits with successful local anesthesia.
• Absence of response to electric pulp testing — Immediately after completion of local anesthetic injection at each treatment visit
  The proportion of treatment visits in which no response is obtained using an electric pulp tester after local anesthetic administration.
• Anesthesia Onset Time — Immediately following local anesthetic injection at each treatment visit.
  Anesthesia onset time will be compared between computer-controlled and conventional local anesthesia. It will be defined as the time from completion of the injection until the child reports numbness and no response is obtained with electric pulp testing. The time will be recorded in seconds.

Trial sites (1)

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